Abstract
Background
Studies of minimally invasive surgery (MIS) approaches to TKA have shown decreased postoperative pain, earlier return to function, and shorter lengths of stay in the hospital. However, it is unclear whether these differences translate into decreased costs or charges associated with care.
Questions/purposes
We asked whether a minimally invasive approach to TKA is associated with lower inpatient charges and direct inpatient costs than the traditional approach.
Patients and Methods
We retrospectively reviewed one high-volume arthroplasty surgeon’s first 100 minimally invasive TKAs with the last 50 traditional TKAs with respect to all perioperative inpatient medical and billing records. Total charges minus implants (which were excluded across groups), total direct costs, and individual cost centers were analyzed.
Results
The mean nonimplant total charge was less for patients receiving a minimally invasive TKA than a traditional TKA ($13,505 versus $14,552). With the numbers available, there was a trend for lower mean direct cost for minimally invasive TKA ($6156) versus traditional TKA ($6410).
Conclusions
The total inpatient charges associated with a minimally invasive TKA were less than those associated with a traditional TKA; however, the magnitude of the difference (7.2%) was modest, and there was no reduction in direct hospital costs. Other studies will need to determine whether any economic benefits associated with minimally invasive TKA accrue after discharge. The decision regarding whether to perform minimally invasive TKA should be made on clinical grounds, as the medical-economic case on the inpatient side is not compelling.
Level of Evidence
Level II, economic analysis. See Guidelines for Authors for a complete description of levels of evidence.
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Acknowledgments
We thank Patrick L. Green MBA, and Jedediah K. White BS, for their contributions with the hospital-based financial data and the study database, respectively. We give special thanks to Leslie Meyer, whose assistance in manuscript preparation was invaluable.
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One or more of the authors (S.S.L.) have received funding from OREF/Zimmer Orthopaedic Career Development Grant (OREF 03-035).
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research.
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King, J.C., Manner, P.A., Stamper, D.L. et al. Is Minimally Invasive Total Knee Arthroplasty Associated with Lower Costs Than Traditional TKA?. Clin Orthop Relat Res 469, 1716–1720 (2011). https://doi.org/10.1007/s11999-010-1648-2
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DOI: https://doi.org/10.1007/s11999-010-1648-2